2019 Coding Reference

Effective April 1, 2013 and while sequestration is in effect, all CMS payments for services will be reduced by 2%.
The fees below do not reflect this reduction. Click here for more information.


Healthcare Associated Infections

Critical Infectious Disease

Women's Health/Sexual Health

Oncology/Genetics
Please select your state:  


Critical Infectious Disease
Test Name CPT® Code Description
Medicare Coverage
National
Medicare Reimbursement
National
Medicaid Reimbursement
Xpert® MTB/RIF 87556 Mycobacteria tuberculosis, amplified probe technique
  CCI   MUE  
$ 41.68
N/A
87798 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism
  CCI   MUE  
$ 38.99
N/A
Xpert® Xpress Flu
87502 influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types
  CCI   MUE  
$ 95.80
N/A
Xpert® Xpress Flu
CLIA Waived
87502-QW influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types
  CCI   MUE  
$ 95.80
N/A
Xpert® Flu+RSV
CLIA Waived
87631-QW respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets
  CCI   MUE  
$142.63
N/A
Xpert® Flu/RSV

Xpert® Xpress Flu/RSV
87631* respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets
  CCI   MUE  
$142.63
N/A
87502** influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types
  CCI   MUE  
$ 95.80
N/A
87634*** respiratory syncytial virus, amplified probe technique
  CCI   MUE  
$ 77.99
N/A
   * If all targets ordered by healthcare provider at same time.
   ** If only Flu is ordered.
   *** If only RSV is ordered.
Xpert® Xpress Flu/RSV CLIA Waived 87631-QW* respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets
  CCI   MUE  
$142.63
N/A
87502-QW** influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types
  CCI   MUE  
$ 95.80
N/A
87634-QW*** respiratory syncytial virus, amplified probe technique
  CCI   MUE  
$ 77.99
N/A
   * If all targets ordered by healthcare provider at same time.
   ** If only Flu is ordered.
   *** If only RSV is ordered.
Xpert® EV 87498 enterovirus, amplified probe technique, includes reverse transcription when performed
  CCI   MUE  
$ 38.99
N/A
Xpert® Ebola^ 87798 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism
  CCI   MUE  
$ 38.99
N/A
Xpert® Xpress Strep A 87651 Streptococcus, group A, amplified probe technique
  CCI   MUE  
$ 38.99
N/A
Xpert® Xpress Strep A
CLIA Waived
87651-QW Streptococcus, group A, amplified probe technique
  CCI   MUE  
$ 38.99
N/A


^For emergency use under an Emergency Use Authorization (EUA).

Healthcare policy, economics and reimbursement information provided by Cepheid is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice. Cepheid encourages providers to submit accurate and appropriate claims for services. It is the provider's responsibility to determine medical necessity, the proper site for delivery of any services and to submit appropriate codes, charges, and modifiers for services rendered. Cepheid recommends that providers consult with payers, reimbursement specialists and/or legal counsel regarding coding, coverage and payment matters.

This website is a private website and is not associated, endorsed or authorized by the Department of Health and Human Services, the Center for Medicare and Medicaid Services or any other public or government organization or agency.



CPT copyright 2018 American Medical Association. All rights reserved.

CodeMap® is a Registered Trademark of Wheaton Partners, LLC.

05/23/2019 07:03:20 54.227.76.35